Effective pupil dilatation with a mixture of 0.75% tropicamide and 2.5% phenylephrine: A randomized controlled trial

Trinavarat, Adisak; Pituksung, Auengporn

doi:10.4103/0301-4738.55070

Cited by 12 publications

(15 citation statements)

References 3 publications

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“…A mixture of reduced concentration of tropicamide and phenylephrine in patients with darkly pigmented irides was reported to be sufficiently effective for pupillary dilatation in indirect ophthalmoscopy 4, 5. This study also showed that the lower concentration of dilating drops in the TPD protocol neither compromised the average gain in pupillary increment nor the mean mydriatic rate at the 60 min mark.…”

Section: Discussionmentioning

confidence: 57%

“…However, these preservatives have been linked to unwanted ocular surface side effects, such as stinging, redness and corneal punctate epithelial erosion. A combination of pre-operative eye drops in one bottle may not only reduce the frequency of multiple eye drop administrations but may also reduce the ocular and systemic complications 3, 4, 5. There were some reports on the efficacy and safety of a combination of tropicamide and phenylephrine,4, 5, 6 but there is no report on a combination of tropicamide, phenylephrine and diclofenac.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of an eye drop mixture for pupillary dilatation: A randomized comparative study

Bhurayanontachai

Saengkaew

Apiromruck

2017

Journal of Optometry

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PurposePupillary dilatation with three types of eye drops is used regularly in the clinic; however, a mixture of these drops in a single bottle may be more beneficial in reducing workloads and resources. This study compared the efficacy in pupillary dilatation between two protocols of dilating drop instillation.MethodsThis prospective, randomized, comparative study included 30 eligible Thai patients. The patients randomly received preoperative pupillary dilatations by either the conventional protocol (1% tropicamide (T), 10% phenylephrine (P) and 0.1% diclofenac (D) in three separate bottles) or the fixed combination (TPD) protocol which had the three types of eye drops mixed in a single bottle in a ratio of 4:3:3. The chi-square test and independent t-test were used to analyze the data.ResultsThe conventional protocol group and TPD protocol group each had 15 patients. Sixty minutes after the initial instillation, all patients in the TPD protocol and 13 patients (86.7%) in conventional protocol achieved at least 6 mm in the shortest diameter. The mydriatic rate between protocols showed no difference. In patients who received the TPD protocol, the systemic effects on the mean arterial blood pressure and pulse rate decreased over time.ConclusionThe mixture of tropicamide, phenylephrine and diclofenac had a comparable efficacy for a pupillary dilatation to the conventional dilating drops in separate bottles. The systemic complications on blood pressure and arterial pulse of the TPD mixture were less than the conventional protocol.Trial registrationTCTR20130325001.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Efficacy of an eye drop mixture for pupillary dilatation: A randomized comparative study

Bhurayanontachai

Saengkaew

Apiromruck

2017

Journal of Optometry

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“…6 Selama ini para ahli telah merekomendasikan penggunaan kombinasi tropikamid dan efinefrin untuk melebarkan pupil. 7,8 Namun, kombinasi kedua obat ini kadang dirasakan kurang efektif pada pasien retinopati diabetika akibat keadaan neuropati yang juga terjadi. Oleh karena itu, perlu dicari obat tambahan yang dapat membantu penetrasi obat sehingga efek midriasis akan lebih mudah dicapai.…”

Section: Pendahuluanunclassified

“…Secara histologis, otot ini dibentuk dari serabut otot polos yang berhubungan dengan stroma iris dan otot dilator pupil. 8 Pada keadaan normal, pupil akan bereaksi terhadap intensitas cahaya. Pupil akan berdilatasi dan konstriksi sebagai reaksi dari perubahan intensitas cahaya yang akan dapat merangsang sistem simpatetik dan parasimpatetik dari pupil.…”

Section: Pembahasanunclassified

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Efektivitas Penambahan Natrium Diklofenak terhadap Larutan Obat Dilatasi Pupil pada Pasien Retinopati Diabetik

Kartasasmita¹,

Sovani²,

Setyohadji³

et al. 2017

mkb

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AbstrakPemeriksaan fundus memerlukan akses visualisasi yang baik. Pada penderita diabetes melitus, pupil sulit lebar menggunakan obat pelebar pupil standar sehingga perlu ditambahkan agen pelebar pupil. Penelitian ini dilakukan di Rumah Sakit Mata Cicendo periode Januari sampai Juli 2014 menggunakan metode double masked rendomized cotrolled trial terhadap 64 mata dari 32 subjek penelitian yang telah didiagnosis menderita retinopati diabetika dengan tingkat yang sama antara mata kiri dan kanan. Dibuat larutan kombinasi campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, 10 mL fenilefrin 5% dan 10 ml 0,1% Na diklofenak (larutan I) dan campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, dan 10 mL fenilefrin 5% (larutan II). Setiap subjek mendapat salah satu larutan pada mata dan larutan yang lain pada sebelahnya secara acak. Dilakukan pemantauan dengan cara memotret pupil pada menit ke-15, 20, dan 25 pada kedua mata. Lebar pupil kedua kelompok perlakuan diukur dengan perangkat lunak khusus (image processing). Dari penenelitian terdapat perbedaan bermakna antara penggunaan larutan I dan larutan II dalam melebarkan pupil baik pada menit ke-15 (t=2,02; p=0,047), menit ke 20 (t=2,23; p=0,029), dan pada menit ke-25 (t=2,041; p=0,045). Larutan kombinasi fenilefrin, tropikamid, dan natrium diklofenak menghasilkan efek dilatasi pupil yang lebih baik dibanding dengan larutan kombinasi fenilefrin dan tropikamid saja pada kasus retinopati diabetes. [MKB. 2017;49(3):199-207] Kata kunci: Dilatasi pupil, natrium diklofenak, retinopati diabetika Effectiveness of Sodium Diclofenac Addition to Pupil Dilatation Agent on Diabetic Retinopathy Patients AbstractFundus examination requires good visualization of fundus. In diabetic patients, it is difficult for the pupil to dilate using the standard pupilarry dilating agent. To achieve proper dilation, special agents have to be added to the standard dilation agent. The study was conducted in Cicendo Eye Hospital from January to July 2014, using double masked randomized controlled trial to 32 patients (64 eyes) who were diagnosed as suffering from diabetic retinopathy with the same grade on both eyes. Eye drop solutions were developed beforehand by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine, and 10 mL of 0.1% diclofenac-natrium (solution I) and also by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine and 10 mL of 5% phenylephrine (solution II). Every subject received one drop of one solution on one eye and the other solution on the other eye in randomly fashion. The observation was performed by taking photographs of the pupil on both eyes 15, 20, and 25 minutes of observation. The resulting pupil photographs were then analyzed and measured using special image processing software and compared. It was revealed that there were statistical differences in pupil dilation between solution I and solution II at 15 minutes (t=2.02; p=0.047), 20 minutes (t=2.23, p=0.029), and 25 minutes (t=2.041, p=0.045). Phenilefrine, tropicamide and diclofenac-natrium combination ...

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Blood oxygenation level‐dependent (BOLD) functional MRI of visual stimulation in the rat retina at 11.7 T

Garza

Muir

et al. 2010

NMR in Biomedicine

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Although optically based imaging techniques provide valuable functional and physiological information of the retina, they are mostly limited to the probing of the retinal surface and require an unobstructed light path. MRI, in contrast, could offer physiological and functional data without depth limitation. Blood oxygenation level-dependent functional MRI (BOLD fMRI) of the thin rat retina is, however, challenging because of the need for high spatial resolution, and the potential presence of eye movement and susceptibility artifacts. This study reports a novel application of high-resolution (111 × 111 × 1000 µm 3 ) BOLD fMRI of visual stimulation in the anesthetized rat retina at 11.7 T. A high-field MRI scanner was utilized to improve the signal-to-noise ratio, spatial resolution and BOLD sensitivity. Visual stimuli (8 Hz diffuse achromatic light) robustly increased BOLD responses in the retina [5.0 ± 0.8% from activated pixels and 3.1 ± 1.1% from the wholeretina region of interest (mean ± SD), n = 12 trials on six rats, p < 0.05 compared with baseline]. Some activated pixels were detected surrounding the pupil and ciliary muscle because of accommodation reflex to visual stimuli, and were reduced with atropine and phenylephrine eye drops. BOLD fMRI scans without visual stimulations showed no significantly activated pixels (whole-retina BOLD changes were 0.08 ± 0.34%, n = 6 trials on five rats, not statistically different from baseline, p > 0.05). BOLD fMRI of visual stimulation has the potential to provide clinically relevant data to probe hemodynamic neurovascular coupling and dysfunction of the retina with depth resolution.

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Effective pupil dilatation with a mixture of 0.75% tropicamide and 2.5% phenylephrine: A randomized controlled trial

Cited by 12 publications

References 3 publications

Efficacy of an eye drop mixture for pupillary dilatation: A randomized comparative study

Efficacy of an eye drop mixture for pupillary dilatation: A randomized comparative study

Efektivitas Penambahan Natrium Diklofenak terhadap Larutan Obat Dilatasi Pupil pada Pasien Retinopati Diabetik

Blood oxygenation level‐dependent (BOLD) functional MRI of visual stimulation in the rat retina at 11.7 T

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